What is Arthritis?
Arthritis is the name given to more than 100 medical conditions that affect the muscles, bones and joints. It may occur in most areas of the body, however, it is most commonly seen in the knees, hips, back and hands (Arthritis Australia, 2017). Symptoms often include redness, stiffness, pain and swelling in the affected areas. While frequently considered to be something that affects older people, arthritis can affect anyone including children and adolescents with two thirds of people living with arthritis being in the 16-60 age range. The four most common forms of arthritis are discussed below.
Osteoarthritis
Osteoarthritis is the most common form of arthritis in Australia. It occurs when the bones in the joints rub together over time resulting in pain, swelling and stiffness. It can make it harder to walk or do other daily activities. Osteoarthritis is more common in women, those over 40 years of age and those with a family history of osteoarthritis (Healthdirect, 2020). Certain lifestyle factors can also increase the risk of developing osteoarthritis such as:
- being overweight which puts your knees and hips at greater risk
- having a previous injury to the joint, such as a dislocation or a fracture commonly affecting knees, hips or hands
- frequent kneeling, climbing and squatting which puts your knees at greater risk
- jobs that involve heavy lifting which puts your hips at greater risk
- repetitive use of the hands which puts the joint in your hands at greater risk
Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease. Normally, the immune system causes inflammation to help control infection, however, in people experiencing rheumatoid arthritis, the immune system attacks the lining of the joints (Garvan Institute of Medical Research, 2021). It is not clearly understood why this occurs. If the inflammation continues the cartilage and bone in the joints can degrade resulting in the joints becoming deformed and movement restricted. Rheumatoid arthritis typically starts between the ages of 25 and 45, however it may also affect young children. This is known as Juvenile Idiopathic rheumatoid arthritis (Garvan Institute of Medical Research, 2021). Certain factors increase the likelihood of developing rheumatoid arthritis including gender, it is more common in females, family history of autoimmune diseases and obesity.
Gout
Gout is an inflammatory form of arthritis which usually develops suddenly, unlike other forms of arthritis which generally develop overtime (Australian Institute of Health and Welfare, 2020). It occurs as a result of higher levels of uric acid in the bloodstream. Uric acid is made by the body naturally as part of digestive processes. When your body makes too much uric acid, high levels in the bloodstream may occur which sometimes results in the uric acid forming crystals. These crystals, known as urate crystals, then deposit in the joints, typically the toe, feet, ankles, knees, elbows, wrists and fingers caused rapid onset pain, swelling and redness (Better health Channel, 2018). Certain factors and conditions may increase the risk of developing gout including:
- being male
- having a family history of gout
- having elevated levels of uric acid in the blood
- drinking too much alcohol (particularly beer)
- eating a diet high in purines such as meat, sweetbreads, offal, shellfish, and fructose
- being overweight or obese
- using diuretics
- having type 2 diabetes, high blood pressure or high cholesterol – these conditions can mean that your kidneys are less able to flush out the urates
- having kidney disease
- crash dieting or fasting.
Ankylosing Spondylitis
Ankylosing Spondylitis (AS) is a form of arthritis that primarily affects the spine. Patients often experience stiffness and pain in the back, neck and buttocks. Unlike other forms of arthritis, AS usually worsens with rest and unlike other types of back pain, it isn’t caused by specific injuries or activities (Arthritis Australia, 2017). The onset is typically between the ages of 15 and 45 years of age and is more likely to occur in patients with a family history of AS.
Treatments
Currently there is no cure for arthritis. Treatments focus on decreasing pain and other symptoms and improving the quality of life. It is important to seek medical attention from a healthcare professional if you experience severe pain or pain that does not respond to simple measures quickly (for example, within 48 hours of starting treatment with simple pain relief).
Medicines
Medications for the treatment of arthritis are dependent on the type and severity of the condition and range from simple over the counter pain relief to prescription medications. Some prescriptions are available from your GP whilst other are only available from specialist doctors and may include oral of injectable medications. To avoid flare ups it is important to take your medication as prescribed. Speak to your pharmacist to help ensure you do not run out of your medication and to provide you with additional support and information to maximise the effects. Many complementary medicines are available for the management of symptoms associated with various types of arthritis. It is important to note that there is no conclusive evidence to support their use. Please always speak to you pharmacist, GP or specialist before commencing, changing or stopping any medication.
Non-drug treatments
Several non-drug treatments play an important role in prevention of a variety of arthritic conditions. Weight reduction plays a pivotal role in maintaining mobility in weight bearing joints such as hips and knees (York, 1995). Where pre-existing joint problems occur, the use of protective practices such as the application of splints, orthoses or reduced activity may minimise damage (Shaw et al., 2007; York, 1995). Surgery is an effective treatment when drug therapy has not been effective or the severity of the condition has progressed (Royal Australian College of General Practitioners, 2018)
Whilst a number of non-drug treatments are often recommended for arthritis, it is important to recognise that there is limited evidence to support their use for arthritis. However, some people have reported benefits from Tai Chi, hot bath therapy, laser therapy and TENS in conjunction with drug therapy (Royal Australian College of General Practitioners, 2018; Shaw et al., 2007). If you are considering treatment with a non-drug therapy, please consult your pharmacist, GP or specialist.
If you are concerned about your pain, please contact one of our friendly pharmacists or your GP.
References
Arthritis Australia. (2017). Ankylosing spondylitis. Retrieved from https://arthritisaustralia.com.au/types-of-arthritis/ankylosing-spondylitis/
Arthritis Australia. (2017). What is arthritis? Retrieved from https://arthritisaustralia.com.au/what-is-arthritis/
Australian Institute of Health and Welfare. (2020). Arthritis. Retrieved from https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/arthritis-snapshot/contents/treatment-management-of-arthritis
Australian Institute of Health and Welfare. (2020). Gout. https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/gout/contents/what-is-gout
Better Health Channel. (2018). Gout. Retrieved from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/gout
Garvan Institute of Medical Research. (2021). Rheumatoid arthritis. Retrieved from https://www.garvan.org.au/research/diseases/rheumatoid-arthritis
Healthdirect. (2020). Osteoporosis. Retrieved from https://www.healthdirect.gov.au/osteoarthritis
Royal Australian College of General Practitioners. (2018). Guideline for the management of knee and hip osteoarthritis. 2nd Ed. Retrieved from https://www.racgp.org.au/download/Documents/Guidelines/Musculoskeletal/guideline-for-the-management-of-knee-and-hip-oa-2nd-edition.pdf
Shaw, K., Zochling, J. & Winzenberg, T. (2007). Nonpharmacological interventions for rheumatoid arthritis. Australian Family Physician, vol. 36. 10, pp 841. Retrieved from https://www.racgp.org.au/getattachment/96125398-2d26-4abf-ba46-e6c233229cc3/attachment.aspx
York, J. (1995). The non-pharmacological treatment of osteoarthritis. Australian Prescriber, 18, pp 2-4. Retrieved from https://doi10.18773/austprescr.1995.001
